ROLE OF POLIDOCANOL IN PERCUTANEOUS SCLEROTHERAPY IN TREATMENT OF ABC - A SINGLE CENTRE STUDY

Abstract

INTRODUCTION: Aneurysmal Bone Cyst (ABC) is a rare, benign, cystic lesion mostly found at the eccentric location of metaphysis of long bones.  ABC constitute 1% of benign bone tumours. ABC is expansile, highly vascular and osteolytic in character. Population of 1st and 2nd decades are vulnerable to ABC. Curettage with bone grafting (auto-graft or allograft) is considered the mainstay of treatment for ABC. Curettage and bone grafting showed high rates of morbidity as well as recurrence. Other advanced treatment modalities include radiotherapy, wide excision and sclerotherapy.   Here, in our retrospective study, we studied aneurysmal bone cysts treated with percutaneous sclerotherapy with polidocanol as a sclerosing agent presented to our hospital for the last 3 years.

MATERIALS AND METHODS: This is a single centre retrospective study conducted in the Department of Orthopaedics in Kurnool Medical College with 23 patients from 2018 to 2021 over three years with 3% Polidocanol as sclerosing agent in percutaneous sclerotherapy as a treatment option for ABC. Postoperatively the patients are evaluated based on clinical and radiological examinations.

RESULTS: Patients were evaluated based on clinical and radiological outcomes. Clinically patients were compared to their own VAS (Visual Analog Sore) score at the time of healing to VAS score during their 1^st visit. The mean VAS during 1^st visit was 7.6. At the time of healing, there were only 2 patients who scored 1 on the VAS score. Radiologically, plain radiographs were observed for ossification. 20 (86.9%) patients achieved complete ossification, 2(8.69%) patients could achieve partial ossification.

CONCLUSION: With this study, we like to present that percutaneous sclerotherapy with 3% polidocanol is effective both clinically and radiologically in the treatment of Aneurysmal Bone Cysts. Our institution has adopted sclerotherapy as part of salvage therapy and as 1st line of treatment in treating ABC tumours.